Fibromyalgia

Fibromyalgia is a chronic disorder causing widespread pain, fatigue, and other symptoms that can interfere with daily activities.

Overview

Fibromyalgia is a chronic disorder that causes widespread pain and tenderness throughout the body, as well as fatigue and trouble sleeping. It is not a form of arthritis, but like arthritis, it can interfere with a person’s ability to perform everyday activities.

Most people with fibromyalgia are women, but men and children can also have this condition. Most people are diagnosed during middle age, and the chance of having it increases as you get older. Fibromyalgia occurs in people of all ethnic groups.

Scientists do not fully understand what causes fibromyalgia, but people with the disorder have an increased sensitivity to pain. There is no cure, but doctors and other healthcare providers can help manage and treat the symptoms. Treatment typically involves a combination of exercise or other movement therapies, psychological and behavioral therapy, and medicines.

Related Terms: Fibromyalgia syndrome

Signs and Symptoms

The main symptoms of fibromyalgia include:

  • Chronic, widespread pain throughout the body or in multiple areas
    • Pain is often felt in the arms, legs, head, chest, abdomen, back, and buttocks. People often describe it as aching, burning, or throbbing.
  • Fatigue or an overwhelming feeling of being tired
  • Trouble sleeping

Other symptoms may include:

  • Muscle and joint stiffness, including morning stiffness
  • Tenderness to touch
  • Numbness or tingling in the arms and legs
  • Problems with concentrating, thinking clearly, and memory — sometimes called “fibro fog”
  • Increased sensitivity to light, noise, odors, and temperature
  • Digestive issues, such as bloating or constipation
  • Headaches
  • Painful menstrual periods
  • Restless legs syndrome

Related Health Effects

A person with fibromyalgia may have two or more coexisting chronic pain conditions. Such conditions can include chronic fatigue syndrome, endometriosis, irritable bowel syndrome, interstitial cystitis, temporomandibular joint dysfunction, and vulvodynia. It is not known whether these disorders share a common cause.

People with certain other diseases may be more likely to have fibromyalgia. These include:

Causes and Risk Factors

The cause of fibromyalgia is not fully known. Studies show that people with the disorder have an increased sensitivity to pain, so they feel pain when others do not. Brain imaging studies and other research have uncovered evidence of altered signaling in neural pathways that transmit and receive pain in people with fibromyalgia. These changes may also contribute to the fatigue, sleep troubles, and “fibro fog” that many people with the disorder experience.

The exact cause may also be related to injury, emotional distress, or viruses that change the way the brain perceives pain.

Additional risk factors include:

  • Genetics: Fibromyalgia tends to run in families, so genetic factors likely contribute to the disorder, though little is known about the specific genes involved. The disorder also occurs in people with no family history of it.
  • Environmental triggers: Researchers believe nongenetic factors also play a role. These may include having a disease that causes pain, such as rheumatoid arthritis, or mental health conditions such as anxiety or depression.
  • Nutritional factors: It has been suggested that deficiencies in vitamin D might worsen fibromyalgia symptoms. Researchers are also investigating whether low magnesium levels contribute to fibromyalgia.

Diagnosis

There is no specific laboratory or imaging test for fibromyalgia. Health care providers diagnose it by examining the patient, evaluating symptoms, and ruling out other conditions. The main symptoms — pain and fatigue — are like many other conditions, so doctors typically try to rule out other causes first.

Doctors may take the following steps to diagnose fibromyalgia:

  • Take your medical history to learn about the location, severity, and duration of pain, and whether you have experienced severe fatigue or cognitive problems, such as confusion or memory issues.
  • Perform a physical exam to examine your joints to see if you may have another condition, such as rheumatoid arthritis or systemic lupus erythematosus (lupus).
  • Order laboratory or imaging tests to help rule out other diseases and conditions.

Treatment and Management

There is no cure for fibromyalgia, so treatment focuses on relieving symptoms. Treatment often involves an individualized approach that may include both medicines and nondrug therapies.

Exercise and movement therapies

Research has repeatedly shown that regular exercise is one of the most effective treatments for fibromyalgia. People with fibromyalgia who have too much pain or fatigue to do vigorous exercise should begin with walking or other gentle exercise and build their endurance and intensity slowly. Low-impact aerobic activities — such as walking, biking, swimming, and water exercises — are especially helpful. Activities that engage the mind and body, such as yoga and tai chi, are also helpful.

Psychological and behavioral therapy

  • Cognitive behavioral therapy (CBT) aims to change the way you think about pain and can be helpful, especially when combined with other types of treatment. This type of therapy can be either one-on-one or in groups with a counselor.
  • Other types of mental health counseling may also be helpful.

Medicines

Medicines can help relieve pain and improve sleep. Your doctor may prescribe more than one type at the same time. You may need to try different drug combinations and dosages before finding relief, and improvement is often gradual. Medicine types include:

  • Antidepressants: Drugs that treat depression may also work for fibromyalgia even if you are not depressed.
  • Anti-seizure medicines: These can lessen pain and improve sleep by interfering with the transmission of pain signals to the brain.
  • Analgesics (pain-relieving medicines): These may be used for people who need additional pain relief. Anti-inflammatory pain medicines are usually not effective because fibromyalgia does not cause tissue inflammation, but they may help with other painful conditions a person with fibromyalgia may have.

Living With Fibromyalgia

Having fibromyalgia can significantly impact your quality of life and your ability to do everyday activities. The following strategies may help.

Staying Active

Exercise is a key component of fibromyalgia therapy. Although pain and fatigue may make exercise difficult, it is important to be as physically active as possible. Research shows that regular exercise is one of the most useful ways to combat fibromyalgia, and even modest levels are helpful. Be sure to check with your doctor before beginning an exercise routine.

Educating yourself and getting support

  • Learn as much as you can about fibromyalgia and join an online or in-person support group with other people who are dealing with it.
  • Having a support network can help you manage difficult times.
  • Visit a mental health professional if emotional problems arise. Research has shown that cognitive behavioral therapy, which teaches skills for better controlling the pain, can be helpful.

Combatting fatigue

Persistent fatigue is one of the most troubling symptoms of fibromyalgia. The following strategies may help you sleep better and feel more rested:

  • Create a relaxing sleep environment and establish a sleep routine.
  • Go to sleep and get up at the same time every day.
  • Reserve your bed for sleeping. Watching TV, reading, or using a laptop or phone in bed can keep you awake.
  • Keep your bedroom dark, quiet, and cool.
  • Avoid stimulants like caffeine and nicotine and limit alcohol intake.
  • Wind down before bed. Avoid working or exercising close to bedtime. Try relaxing activities such as listening to soft music, meditating, or taking a warm bath.
  • Pace yourself during the day. Try not to use up all your energy each day, because doing too much can make your symptoms worse.

Find Clinical Trials

Clinical trials uncover better ways to prevent, diagnose, treat, and understand diseases and conditions. To ensure results apply to everyone, volunteers of all ages, sexes, and backgrounds, including both healthy individuals and those with specific medical conditions, are needed. Find clinical trials on fibromyalgia.

Find Treatment

Fibromyalgia treatment often requires a team approach. It is primarily treated by:

  • Primary care providers (PCPs), such as internists, who specialize in the diagnosis and medical treatment. Most people with fibromyalgia are managed by their PCPs.
  • Rheumatologists, who specialize in arthritis and other diseases of the bones, joints, and muscles.

Other healthcare professionals who may be involved in your care include:

  • Exercise physiologists, who are trained in understanding the body’s response to physical activity.
  • Mental health professionals, who help people cope with difficulties in the home and workplace that may result from their medical conditions.
  • Pain management specialists, who are trained in the evaluation and treatment of pain.
  • Physical therapists, who improve quality of life through prescribed exercise, hands-on care, and patient education.
  • Sleep specialists, who address problems related to sleep, sleep disorders, and sleep health.

Community Support

The following organizations provide information and resources related to fibromyalgia:

Note: This resource list is for informational purposes only. It is not comprehensive, and an organization’s inclusion does not constitute an endorsement by NIH.  

Research Information

The National Institutes of Health (NIH) is the largest public funder of biomedical research in the world. NIH invests most of its budget in medical research seeking to enhance life and to reduce illness and disability. NIH-funded research has led to breakthroughs and new treatments helping people live longer, healthier lives, and building the research foundation that drives discovery.

NIH is supporting research to understand the causes of fibromyalgia and to develop new treatment strategies. Current research efforts include:

  • Studying the pathways that underlie pain in fibromyalgia and other chronic pain diseases to find ways to identify more effective pain management approaches.
  • Using brain imaging studies to assess how this type of therapy affects neural pathways, with the goal of improving pain management through improved psychosocial interventions.
  • Developing imaging and laboratory tests that distinguish fibromyalgia from other conditions that cause pain.
  • Assessing the efficacy of various types of therapy and dietary supplements, such as light, music, exercise, or heat therapy on fibromyalgia symptoms.

Find NIH-funded research projects using NIH RePORTER, a searchable database of current and past research projects supported by NIH and other federal agencies.